Flu virus sleuths race to ward off worst

RICHMOND -- Far from hospitals and morgues, disease sleuths are racing to understand the pace and pattern of California's deadly influenza season.

Sample 14603? This tiny vial of mucus -- one of thousands tested this winter by the state Department of Public Health lab -- is found to be infected with the virus known as influenza A, subtype H1N1.

Soon the patient recovers, or is buried.

But the virus's identity -- revealed in merely two hours -- is rushed into the lab's vast database, helping paint a picture of this winter's widespread flu outbreak. The virus then may be stored in a cavernous freezer that holds thousands of samples dating back to the 1950s for study in decades to come.

"We wait with bated breath," said Debra Wadford, who supervises the virus hunt as chief of the lab's Respiratory and Gastroenteric Disease section.

"What's it going to be? When will disease peak? We don't know," she said. "This is great stuff."

Behind gates, locked doors and security cameras, the team is a bulwark in the state's defense against about 300 viral and bacterial invaders, from flu to hantavirus, West Nile and diseases such as Rocky Mountain spotted fever.

Its cadre of gloved and white-coated technicians are homicide detectives in daily murder mysteries. Established 75 years ago, it is the nation's oldest state public health virology lab and a key player in the national and international disease surveillance network. Such vigilance means officials can sound the alarm if an entirely new and frightening microbe appears in California.

"We pick up things that are suspicious of being a novel virus," said Dr. James P. Watt, chief of the lab's Division of Communicable Disease Control. "It is important that they be identified as early as possible."

This winter, their attention is riveted on flu. Understanding flu evolution -- and especially which mutations can change behavior overnight -- is essential for estimating the threat of new strains.

The virus's genetic makeup, stored in eight single strands of RNA, determines whether it has suddenly turned resistant to medicine, or whether a vaccine is protective or futile. In its mildest form, flu and its complications kill as many as 20,000 Americans a year. In its most lethal forms, it kills many more: 34,000 Americans in 1968, 70,000 in 1957 and at least 675,000 in 1918.

This season's influenza had claimed the lives of 52 more Californians by last week, driving the number of flu-related deaths nearly 50 percent higher than last year's end-of-January total.

The most recent testing found flu viruses in less than a third of 5,100 samples in Richmond and the labs it oversees. Of those successfully identified, 564 were the H1N1 or "swine flu" strain, which is particularly dangerous to middle-aged adults who are not vaccinated.

Such details help doctors decide to treat patients aggressively with antiviral drugs and other tools, or just let a harmless strain of the virus run its course. The information also guides creation of next year's vaccine.

Lab tests told us that influenza season started early this year. Positive results started coming in early December, then exploded later that month, several weeks earlier than last year and six weeks earlier than the 2011-12 season.

Every morning, FedEx trucks deliver samples from around the state to the lab, called the Viral and Rickettsial Disease Laboratory. Kept chilled, the samples are unpacked, dropped into vials and prepared for testing.

The lab is most reliant on an $85,000 machine that performs a procedure known as polymerase chain reaction, multiplying bits of genetic material to identify tiny pieces of viral RNA swimming in oceans of molecular contamination.

Over time, the accumulated data will shed light on when and why California's flu emerged. It will reveal how flu's prevalence has changed over time. It might help scientists predict disease trends or outbreaks.

Some samples remain a mystery, their secrets unrevealed by testing.

Frozen at 94 degrees below zero Fahrenheit, the samples are stored in freezers kept in a maze of rooms along identical white corridors. They may remain there for decades until requested for study.

It is a unique treasure trove, Watt said.

"Flu is mysterious," he said. "We can go back and ask: What changed? Why is it seasonal? Why does one strain pop up one year and another pop up another year? We're still scratching our head."